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Fixed Bridges
What is a bridge?
A bridge is a dental appliance that
replaces one or more natural
missing teeth, thereby "bridging"
the space between two teeth. Fixed
bridges are cemented into place
next to the "abutment" teeth -the
surrounding teeth on either side of
the space, or "span." Unlike
removable partial dentures, fixed
bridges cannot be taken out of the
mouth by the patient.
A fixed bridge is a device
that typically consists of three
units-a pontic (a false tooth) fused
between two crowns that are
cemented onto the abutment teeth.
Who should get a bridge?
If you are missing any teeth and
are committed to maintaining good
oral hygiene practices, you may be
a good candidate for a bridge. A
bridge is the most natural choice to
fill the space in your mouth left by
missing teeth. If left unfilled, this
space can cause the surrounding
teeth to drift out of position and
can cause teeth and gums to
become more susceptible to tooth
decay and gum disease that can
cause further tooth loss. Fixed
bridges not only correct an altered
bite, improve your chewing ability
and speech, but they also safe-
guard your appearance by
preventing the collapse of your
facial features that can cause
premature wrinkles and age lines.
What types of bridges are there?
Besides traditional bridges,
another popular design is the resin
bonded or "Maryland" bridge,
primarily used for the front teeth.
This is usually the most
economical choice when the
abutment teeth are healthy and
don't contain large fillings. The
pontic is fused to metal bands that
can be bonded to the abutment
teeth with a resin cement and
hidden from view, reducing the
amount of preparation on the
adjacent teeth.
A cantilever bridge may be
used if there are teeth on only one
side of the span. This involves
anchoring the pontic to one side
over one or more natural, adjacent
teeth. If there are no adjacent teeth
to act as anchors, your dentist may
recommend an implant-a metal
post that is surgically imbedded
into the bone and capped with a
crown as an abutment.
In some cases where the span
is large, your dentist may
recommend a removable partial
denture or even an implant-
supported prosthesis.
What procedures are involved?
For a traditional fixed bridge, the
first appointment consists of the
dentist reducing the adjacent
abutment teeth that will act as
anchors. Impressions are made,
from which a metal framework,
including the pontic, is
created. By the second
appointment, the final bridge is
fitted over the teeth.
The total treatment time is
usually between two or four
weeks, depending on the type of
bridge. However, because it is
often difficult to match the natural
shade of your teeth, the treatment
time may be longer.
How do I care for a bridge?
With a bridge, it is more important
than ever to brush, floss and see
your dentist regularly. If you do
not control the buildup of food
debris and plaque-the sticky film
of bacteria formed from food
acids--your teeth and gums can
become infected, requiring further
treatment and resulting in possible
loss of the bridge. Your dentist
may also recommend using floss
threaders that
help remove bacteria from hard to
reach spaces between the bridge
and adjacent tee(h and gums.
If you maintain optimal oral
hygiene care, you can expect your
fixed bridge to last as many as 8-
10 years, or even longer.
Sources: Robert Margolin, DDS, FAGD;
"An Update on Conventional
Fixed Bridges
Part
I:
Patient
Assessment and Selection," by D.L.
Gutteridge, et al., Dental Update, April
1994; Inlays, Crowns and Bridges, by
Leslie C. Howe, et. al., Butterworth-
Heinemaann LId., 1993; "Crown and Bridge
Procedures' Success Begins with Home
Care," GP, Dec. 1992; Change Your Smile,
by
Ronald
E.
Goldstein,
DDS,
Quintessence Publishing Co., Inc., 198B;
"Fixed Bridges and Crowns," American
Dental Association,
1985.
